Mucormycosis in intensive care unit: surgery is a major prognostic factor in patients with hematological malignancy

Annals of Intensive Care
Johanna ClaustreNicolas Terzi

Abstract

Mucormycosis is an invasive fungal infection, with an increasing incidence especially in patients with hematological malignancies. Its prognosis is poor because of its high invasive power and its intrinsic low susceptibility to antifungal agents. We aimed to describe the epidemiology of mucormycosis in intensive care units (ICU) and evaluate the outcomes. We performed a retrospective multi-center study in 16 French ICUs between 2008 and 2017. We compared the patients who survived in ICU and the patients who did not to identify factors associated with ICU survival. Then, we focused on the subgroup of patients with hematological malignancies. Mucormycosis was diagnosed in 74 patients during the study period. Among them, 60 patients (81%) were immunocompromised: 41 had hematological malignancies, 9 were solid organ transplant recipients, 31 received long-term steroids, 11 had diabetes, 24 had malnutrition. Only 21 patients survived to ICU stay (28.4%) with a median survival of 22 days (Q1-Q3 = 9-106) and a survival rate at day 28 and day 90, respectively, of 35.1% and 26.4%. Survivors were significantly younger (p = 0.001), with less frequently hematological malignancies (p = 0.02), and less malnutrition (p = 0.05). Median surviva...Continue Reading

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Citations

Jan 9, 2021·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Valliappan MuthuArunaloke Chakrabarti
Apr 6, 2021·Journal of Pediatric Endocrinology & Metabolism : JPEM·Nosrat GhaemiSara Shirdelzade
Jul 7, 2021·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Kathrin RotheTobias Lahmer
Aug 31, 2021·Beni-Suef University Journal of Basic and Applied Sciences·Ranjan K MohapatraLucia Pintilie

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Methods Mentioned

BETA
PCR

Clinical Trials Mentioned

NCT03387696

Software Mentioned

R
R Foundation for Statistical Computing

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Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.